Last week the House voted—for the 37th time—to repeal the Affordable Care Act. Everyone knows that repeal will never pass the Senate. Some suggest that legislators might better spend their time (and our tax dollars) figuring out how to create jobs.

Even the Congressional Budget Office (CBO) couldn’t take this 37th vote seriously. When preparing for this latest showdown, Republican Paul Ryan requested an update to CBO’s July 2012 estimate that repealing the ACA would cost more than it would save, increasing the deficit by some $109 billion over the coming decade (2013-2022.)

CBO added that when it does have time to do an update, it expects similar results. Repealing health care reform would add to the deficit.

Are Republicans Crazy . . . Or Cunning?

You might think that by continuing to obsess over a bill that will never succeed, Republicans are once again exhibiting their self-destructive tendencies. But I would argue that House Republican leaders are not crazy, at least not in a way that is easy to understand. They’re cunning.

Ask yourself this: How many people skimmed or half-heard the news stories telling them that the House had passed a bill to repeal Obamacare?

I quoted Greenstein in April, in a post that originally appeared on HealthInsurance.org. There, I explained that Ryan’s budget would shift Medicare costs to seniors and slash Medicaid, while simultaneously offering tax breaks for Americans perched on the top of a our income ladder.

Under the newest version of the Ryan plan, Washington would give seniors a voucher equal to the cost of the second-cheapest private-sector Medicare plan in their region. In theory, this gives seniors “choice” — the opportunity to pick a Medicare policy that best suits their needs, and their pocketbook.

Out of the rubble of the failed budget deficit negotiations, it seems a new movement is afoot to transform Medicare into a “premium support” program with the goal of moving more seniors and the disabled into the private insurance market.